Purdue University, West Lafayette, IN, USA.
J Athl Train. 2013 May-Jun;48(3):431-5. doi: 10.4085/1062-6050-48.2.21. Epub 2013 Feb 20.
To raise awareness among health care providers caring for an active population to an uncommon genetic mutation that increases the risk for a potentially fatal venous thromboembolism.
A 19-year-old previously healthy female collegiate soccer athlete complained of coughing and progressively decreased exercise tolerance, which were attributed to a recent illness and lack of sleep. Later that evening, she complained of dyspnea and pleuritic pain and was referred to the emergency department. Bilateral pulmonary emboli were identified with computed tomography, and a hypercoagulable panel revealed that the patient was heterozygous for the factor V Leiden mutation.
Pneumonia, pneumothorax, pericarditis, pleuritis, gastroesophageal reflux disease, pulmonary embolism.
Intravenous heparin therapy was initiated immediately in the emergency department. This was followed by inpatient anticoagulant therapy for 5 days and outpatient anticoagulant therapy for an additional 12 months. During this time, the patient was unable to participate in soccer drills or return to competition and was limited to conditioning activities due to the risk of increased bleeding time.
Documented cases of pulmonary embolism in a young athletic population are rare and are usually associated with genetic risk factors. Factor V Leiden is a relatively uncommon genetic mutation that dramatically increases the risk for venous thromboembolism. Although the fatality rate in this population is low, fatality is preventable if the condition is recognized early and managed properly.
Athletes should be encouraged to communicate with their athletic trainers regarding any changes in health status or medication usage. When an athlete presents with nonspecific symptoms such as dyspnea and chest pain, athletic trainers should consider the possibility of pulmonary embolism. A high degree of suspicion results in early diagnosis and treatment and may prevent a fatal event.
提高关注活跃人群的医疗保健提供者对一种增加潜在致命静脉血栓栓塞风险的罕见基因突变的认识。
一名 19 岁的健康女性大学生足球运动员抱怨咳嗽和逐渐降低的运动耐量，这些症状归因于最近的疾病和缺乏睡眠。当晚晚些时候，她抱怨呼吸困难和胸膜炎疼痛，并被转介到急诊部。计算机断层扫描显示双侧肺栓塞，高凝面板显示患者为因子 V Leiden 突变的杂合子。
肺炎、气胸、心包炎、胸膜炎、胃食管反流病、肺栓塞。
急诊室立即开始静脉注射肝素治疗。随后进行 5 天的住院抗凝治疗和 12 个月的门诊抗凝治疗。在此期间，由于出血时间延长的风险，患者无法参加足球训练或重返比赛，只能进行调节活动。
年轻运动员人群中罕见有记录的肺栓塞病例，通常与遗传风险因素有关。因子 V Leiden 是一种相对罕见的基因突变，可显著增加静脉血栓栓塞的风险。尽管该人群的死亡率较低，但如果及早发现并正确治疗，死亡率是可以预防的。
应鼓励运动员与他们的运动教练沟通任何健康状况变化或药物使用情况。当运动员出现呼吸困难和胸痛等非特异性症状时，运动教练应考虑肺栓塞的可能性。高度怀疑会导致早期诊断和治疗，并可能预防致命事件。
